Comparison of surgical with nonsurgical treatment for fractured mandibular condyle - a study

ABSTRACT

Condylar fractures are the second most-common fractures of the mandible. The purpose of this study was to compare the surgical [open reduction+internal fixation] and nonsurgical [closed reduction+immobilization] treatment of mandibular condylar fracture in terms of occlusion and maximum mouth opening[inter-incisal distance of the jaws] after these two procedures. The study followed a prospective comparative design and was carried out at the Department of Oral and Maxillofacial Surgery, King Edward Medical University/ Mayo Hospital, Lahore on sixty patients with uni-lateral condylar fractures [neck and /or subcondylar]. Thirty patients were treated by nonsurgical method and thirty by surgical method. At different intervals of their post-operative visits, patients were evaluated in terms of occlusion and maximum mouth opening to assess the difference between the two groups. Patients treated by nonsurgical treatment i.e. closed reduction had greater percentage of malocclusions [44%] at the final post operative visit i.e. one year, as compared with patients treated by surgical treatment i.e. open reduction and internal fixation [8.3%] p=0.005. Similarly patients treated surgically exhibited better improvement in maximum inter incisal opening [46mm+4.50] than patients treated non-surgically [37mm+5.50] at the final post operative visit i.e. one year [p=<0.05]. Based on this study, more consistent occlusion and better improvement in maximum mouth opening can be expected when fractures of the condyle are treated by surgical technique